Osibogun: How We Tackled Ebola Outbreak in Nigeria

Former Chief Medical Director of the Lagos University Teaching Hospital (LUTH), Idi-Araba, Prof. Akin Osibogun, played a prominent role during the outbreak of Ebola virus in 2014. He recently shared his thoughts on how the ‘war’ was won. Martins Ifijeh writes

Even though it is now three years and seven months since Nigeria experienced the first ever outbreak of the dreaded Ebola virus, where seven persons lost their lives from 19 confirmed cases, it still seemed just like yesterday in the heart of many Nigerians because of the anxiety, uncertainty and shock it brought along with it.

It was a period alarm bells were set off, not only in Nigeria, but all over the world, as the fear was that it would trigger an apocalyptic epidemic that would make the outbreaks in Liberia, Sierra-Leone and Guinea a child’s play.

The fear was somewhat justifiable considering that the country has a huge population of over 180 million, with Lagos, where the index case, Patrick Sawyer from Liberia landed, having a cosmopolitan nature withover 21 million people. And coupled with the fact that for eight months, the virus was already killing hundreds of people in smaller countries like Liberia and Sierra-Leone in droves.

This prompted a barrage of precautionary measures from the federal and Lagos State governments, World Health Organisation (WHO), several health institutions, experts,stakeholders, and not forgetting First Consultant Hospital, where the index case was treated for malaria, and subsequently diagnosed of Ebola virus.

Among those who played a prominent role in tackling the three-months-span of the outbreak in Nigeria was the former Chief Medical Director (CMD), Lagos University Teaching Hospital (LUTH), Idi-Araba, Prof. Akin Osibogun, who, because of his position at the time was very strategic to the success or failure of tackling the outbreak in Lagos, Nigeria’s commercial city.

Making a presentation at the Health Writers Association of Nigeria (HEWAN) Annual Symposium in Lagos recently, the Professor of Public Health chronicled some of the events that shaped the successes recorded during the outbreak all within three months, an approach, he said took some African countries three years to come up with and achieve results.

According to him, a unique factor that shaped the successes was the unity experienced both from the federal and Lagos State governments, noting that they both had a common focus of preventing the spread of the disease and treating those already infected.

“During the outbreak, there was nothing like Peoples Democratic Party (PDP) or All Progressives Congress (APC). There was strong unity,” Osibogun noted.

He said initially when news of the outbreak broke, the country was not prepared because there was no capacity at the time to say it was Ebola virus or not. “Though we had some of the facilities at LUTH, some others were immediately put together to achieve what we needed.

“Common sense was also helpful in putting together all we needed for diagnosis of the virus. It took us two to three days before we made a working diagnosis. Because if we were able to identify the virus immediately the news broke, we would have been able to suppress the outbreak faster than we did.

“During these first few days, a diplomatic row was almost imminent because First Consultant Hospital and the doctors on ground had already been threatened with sanctions because the Liberian Government through their embassy here wanted the patient moved from the hospital, but Lagos State Commissioner for Health, Jide Idris and the hospital refused. Even the Liberian Ambassador personally visited the hospital on the issue. They were citing that patients can’t be held against their will.

“But the hospital and the Lagos State Government refused because by law they can hold a patient against his/her will if they believed discharging the patient may become a threat to public health.”

He said even when Mr. Sawyer eventually died, the Lagos State Government stood its ground that the corpse would not be released. “This was very helpful in assisting us identify the virus.” Lagos State Government had some infrastructure on ground which was useful in preparing for outbreaks and emergencies.”

Osibogun said one other hurdle they needed to cross at the time was speedily setting up a treatment centre, which was not available before the outbreak. “We didn’t have a treatment centre for Ebola virus but it was rapidly established. You know we had the mainland infectious diseases hospital which was used to treat tuberculosis and similar infections. We had to make a rapid decision in managing this disease. And at this point we didn’t have a plan.

“So at one of the meetings with Dr. Idris, we made a decision that instead of allowing every hospital to admit Ebola patients, there should be a designated hospital where all patients suspected to having Ebola would be admitted. That was how we decided to use Mainland Hospital.

“But the challenge at the time was that there were patients at the hospital who were already accessing healthcare for different ailments. So we had to convince them to relocate so that patients suspected to having Ebola could be admitted there. That was how we established the treatment centre in Yaba,” he added.

“There was no APC or PDP. Everybody decided to work together. Lagos, an APC state, and the federal government under PDP had so much synergy. Same with our partners, including international agencies and experts.”

He said at the time, what he saw on the faces of most of the international experts was that of fear and worry, as they believed the outbreak would snowball into infecting millions of Nigerians because of the huge population of the country and the level of healthcare generally in the country.

“After a couple of days they began to see the level of professionalism put out by our team and the infrastructure put on ground by the Lagos State Government. One of the structures on ground in Lagos was that, every local government already had disease notification officers.

“Many of such structures we had on ground really helped. Some of which was on contact tracing, diagnosis, among others. With all these in place, it took us only three months to address the issue, while it took some countries about three years.”

He said the Lagos State Government was magnanimous enough to release enough funds to tackle the outbreak, adding that the lack of it would have caused a big mess for the country. “This was the leadership Lagos State showed. Perhaps if the outbreak was in another state, the one million Ebola cases forecasted in Nigeria by international agencies would have happened.

“At that time, we were working with two different cases, ‘Ebola likely’ or the ‘Ebola Unlikely’. For ‘Ebola likely’, we had special ward for them. Then health workers/experts specially trained were the only once visiting that ward. And what we preached then was that they should sit down one meter away from Ebola patients. We lost a lot of resources during the outbreak. I want to say that it is much cheaper to be prepared before outbreak than during the outbreak,” the public health expert explained.

He said while the country is still reveling on the successes made in combating the virus, the country must ensure the 2014 outbreak remains the last for the country.

He called for strengthening of the country’s healthcare system, as that remains a guaranty in tackling outbreaks no matter how dreadful they seem.

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